Tennessee stands at the bottom when it comes to maternal health in America. According to the March of Dimes 2025 Report Card, our state’s maternal mortality rank is at the very bottom of the list.
Even more concerning: perinatal mental health conditions are now recognized among the leading causes of maternal death, accounting for 23% of deaths during and right after pregnancy.
At the intersection of these two statistics lies both a challenge and an opportunity.
Many mothers in Tennessee face birth trauma, NICU stays, anxiety, depression, OCD and PTSD – conditions that too often go untreated or under-recognized. Without timely mental health intervention, the risk for severe outcomes rises.
But mental health screening remains Tennessee’s most preventable gap in maternal care. The March of Dimes Report Card notes that Tennessee failed to meet the national benchmark for postpartum mental health screening. The reality: depression screening takes less than two minutes using the Edinburgh Postpartum Depression Screening Tool and can be administered by any trained provider. Yet Tennessee lacks a consistent, state-wide mandate and enforcement, meaning thousands of at-risk mothers still go unscreened, untreated, and at higher risk for preventable complications.
I launched The Postpartum Den, Nashville’s first intensive maternal mental health program, with this data and these system gaps in mind. Our model delivers intensive, perinatal specific treatment in the actual window of pregnancy and postpartum, when mothers and babies are most at risk.
Our program brings high-frequency, clinician-led care to pregnant and postpartum mothers experiencing emotional, relational, or psychological distress — whether from trauma, anxiety, depression, intrusive thoughts, or the overwhelming transitions that can follow birth. We’re actively working on contracts with Medicaid and the VA to reach the most at-risk populations; mothers in low-resourced communities, military and veteran mothers, and women whose trauma is layered and complex.
The Postpartum Den was intentionally built to intervene in the window when vulnerability is highest to change outcomes. Because in Tennessee, when a mother’s mental health slips, both lives hang in the balance. Systemic change starts with access, specialization, and urgency and if The Postpartum Den can shift even a fraction of that reality with one mother at a time, it’s a start worth making.
